Donor Hearts Being Rejected While Need for Transplants Increase

According to a new
study by researchers at the Stanford University School of Medicine, despite a
growing need for donor hearts, surgeons and transplant centres nationwide have
been rejecting hearts donated for transplantation.

The rejection is due to
the hearts being marginal i.e. with undesirable qualities such as the wrong
size, an older donor etc. Also, there is a certain variation in donor heart
rejection. Some hearts rejected in one region are being accepted in another.

Kiran Khush, MD,
Assistant Professor of Cardiovascular Medicine points out that surgeons and
transplant centres have become more conservative over the last 15-2 years. This
is troublesome since there is already a shortage of donor hearts and an
increase in critically ill patients awaiting heart transplantation. Khush is
the lead author of this study which has been published in the American Journal of Transplantation.

Estimates indicate that
there are more than 20,000 patients in the US who could benefit from heart
transplant surgery each year. However, only 1,949 patients actually received
the transplants in 2011. The findings of the study highlight the need for a set
of consistent, scientifically based guidelines that should be provided to
surgeons and transplant centres so that there is a standardised method of
determining whether a donor heart could be used for transplantation.

"There is likely a significant number of suitable donor
hearts that are not getting used," said John Nguyen, a co-author of the
study who is trained as a nurse and works as part of a clinical team at the
Oakland-based California Transplant Donor Network, a federally designated organ
procurement organization that helps facilitate organ donation to transplant centres
across the nation. "Creating a more systematic way of evaluating these
hearts based on scientific evidence could increase the number of heart
transplants."

Khush also highlights
that they receive donor heart offers that they are not sure if they should
accept. Surgeons also vary as to which hearts they will accept but while this
goes on, there are patients who get sicker and even die because of long wait
times for a donor heart. Khush stresses the importance of increasing the supply
as it is an issue of great concern.

Data from the Organ
Procurement and Transplantation Network on all potential cardiac donors from
1995-2010 shows that of the 82,053 potential donor hearts, only 34 percent were
accepted and 48 percent were rejected. This means that only one in three available
donor hearts is currently accepted for transplantation. This is definitely not
enough to meet the demand for donor hearts. The data also shows a significant
decline in donor heart acceptance - from 44 percent in 1995 to 29 percent in
2006. The figure slightly increased to 32 percent in 2010.

Hearts are rejected for
several reasons including small size, advanced age, donor co-morbidities such
as hypertension and diabetes etc. Generally speaking, any donation by someone
older than 60 who has HIV, hepatitis C or heart disease is rejected. In
addition, there are a lot of criteria that vary from surgeon to surgeon and centre
to centre.

heart transplant, donor hearts, heart disesae, surgeons, transplant centres
According to a newstudy by researchers at the Stanford University School of Medicine, despite agrowing need for donor hearts, surgeons and transplant centr